Active NPI
Laura Dianne Nutt, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1972932473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 68753
- Practice address
- 4232 Heritage Trace Pkwy
Fort Worth, TX 76244-5375 - Phone
- (817) 484-6523
- Fax
- (817) 447-3299
- NPI assigned
- Nov 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 68753 | TX | Primary |
Addresses
Primary practice location
4232 Heritage Trace Pkwy
Fort Worth, TX 76244-5375
Mailing address
4232 Heritage Trace Pkwy
Fort Worth, TX 76244-5375
Phone (817) 484-6523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68753 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412899200000",
"number": "1972932473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4232 HERITAGE TRACE PKWY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762445375",
"telephone_number": "817-484-6523",
"fax_number": "817-447-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4232 HERITAGE TRACE PKWY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762445375",
"telephone_number": "817-484-6523",
"fax_number": "817-447-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUTT",
"first_name": "LAURA",
"middle_name": "DIANNE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-05",
"last_updated": "2014-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "68753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.